Beyond group differences: Exploring the preliminary signals of target engagement of an executive function training for autistic children.

The moderation and mediation questions were post-hoc and highly exploratory, and the authors say the findings need replication. The sample size limited power, so a smaller mediation effect could have been missed. The sample was not diverse by race or ethnicity. ADHD and anxiety were measured as questionnaire features, not formal diagnoses. The study did not confirm anxiety diagnoses with a follow-up clinical interview. The training package combined computer games, metacognitive coaching, and caregiver check-in, so the contribution of any single component cannot be separated. The intervention was delivered by graduate students or research assistants, so its fit with typical occupational therapy practice is not shown.

The supplied text states that the Eunice Kennedy Shriver National Institute of Child Health and Human Development funded the work. It does not list author competing interests.

Do not read the 98 ms faster stop-signal reaction time as evidence that the computer games plus metacognitive coaching and caregiver check-in package improves everyday executive function. The effect was exploratory, appeared only in a subgroup with clinically significant ADHD features, and did not explain parent-reported outcomes.